Multi-aspect analysis of ureteral access sheath usage in retrograde intrarenal surgery: A RIRSearch group study

作     者：Oktay Özman Hacı M.Akgül Cem Başataç Önder Çınar Eyüp B.Sancak Cenk M.Yazıcı Bülent Önal Haluk Akpınar 

作者机构：Gaziosmanpasa Training and Research HospitalUrology ClinicİstanbulTurkey TekirdağNamık Kemal UniversitySchool of MedicineDepartment of UrologyTekirdağTurkey Group Florence Nightingale HospitalsDepartment of UrologyİstanbulTurkey Zonguldak Bulent Ecevit UniversitySchool of MedicineDepartment of UrologyZonguldakTurkey Çanakkale Onsekiz Mart UniversitySchool of MedicineDepartment of UrologyÇanakkaleTurkey İstanbul University-CerrahpaşaCerrahpaşa Medical FacultyDepartment of UrologyİstanbulTurkey 

出 版 物：《Asian Journal of Urology》 (亚洲泌尿外科杂志（英文）)

年 卷 期：2024年第11卷第1期

页      面：80-85页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Stone Retrograde intrarenal surgery Ureteral access sheath Urolithiasis Kidney 

摘      要：Objective:To evaluate the effect of ureteral access sheath(UAS)use and calibration change on stone-free rate and complications of retrograde intrarenal surgery(RIRS).Methods:Data from 568 patients undergoing RIRS for kidney or upper ureteral stones were retrospectively ***,patients were compared after 1:1 propensity score matching,according to UAS usage during RIRS(UAS used[+]87 and UAS non-used[−]87 patients).Then all UAS+patients(n=481)were subdivided according to UAS calibration:9.5-11.5 Fr,10-12 Fr,11-13 Fr,and 13-15 *** outcomes of the study were the success and complications of ***:Stone-free rate of UAS+patients(86.2%)was significantly higher than UAS−patients(70.1%)after propensity score matching(p=0.01).Stone-free rate increased with higher caliber UAS(9.5-11.5 Fr:66.7%;10-12 Fr:87.0%;11-13 Fr:90.6%;13-15 Fr:100%;p0.001).Postoperative complications of UAS+patients(11.5%)were significantly lower than UAS−patients(27.6%)(p=0.01).Complications(8.7%)with 9.5-11.5 Fr UAS was lower than thicker UAS(17.2%)but was not statistically significant(p=0.09).UAS usage was an independent factor predicting stone-free status or peri-and post-operative complications(odds ratio[OR]3.654,95%confidence interval[CI]1.314-10.162;OR 4.443,95%CI 1.350-14.552;OR 4.107,95%CI 1.366-12.344,respectively).Conclusion:Use of UAS in RIRS may increase stone-free rates,which also increase with higher caliber *** usage may reduce complications;however,complications seemingly increase with higher UAS calibration.